Prevalence and Predictors of Substance Use Disorder Due to Gabapentinoids in Patients With Chronic Non-Cancer Pain: A...

The increase in the use of gabapentinoids in the treatment of patients with chronic non-cancer pain (CNCP) has drawn attention to the possibility of substance use disorder (SUD) due to gabapentinoids. Systematic literature reviews have provided evidence of the risk of SUD due to gabapentinoids within substance-using populations. Despite concerns, prescription rates of gabapentinoids continue to increase in many countries, such as the USA, the UK, and Germany. Gabapentinoids are frequently prescribed off-label for chronic pain regardless of neuropathic pain diagnosis, increasing the risk for problematic use. A recent literature review suggests that there is a potential for SUDs in CNCP, but robust data focusing specifically on this population is lacking. The present study aims to address this by investigating SUD due to gabapentinoids in a cohort of patients with CNCP.

This study employs an anonymous, self-reported questionnaire-based cross-sectional design. It was conducted among CNCP patients in n = 11 general practitioner practices across two regions of Germany. A total of 93 adult patients with CNCPs who were treated with gabapentinoids were included in the final analysis. The questionnaire utilized was based on validated and established diagnostic instruments, including questions aligned with the DSM-5.

The data revealed a prevalence of 26.9% (n = 25) for at least a mild SUD in the sample, including 5.4% with severe SUD. Logistic regression with sociodemographic, pain-related, and psychological variables revealed that male sex was a statistically significant predictor of SUD due to gabapentoids (Exp(B) = 3.97, p < 0.05; CI: 1.40-11.26). This analysis is limited by sample size and self reported data.

The results suggest a relevant risk for SUDs due to gabapentinoids in CNCP patients. Special care should be taken when prescribing gabapentinoids to patients with CNCP. Male sex as a predictor of SUD due to gabapentinoids should be further investigated.